Wednesday, August 13, 2014

Choosing the Right Facility for an LBD Patient

It's amazing how many care facilities are out there.  There are some that are really amazing - and have very amazing prices attached!  But are you getting your money's worth?  Are you getting the care for your loved one, that they need?

Here are some things I learned while shopping for Mom:

1.  How does the Atmosphere/Aura compare to what your loved one is used to and needs?
         Now, Mom needs open space.  She has claustrophobia and high anxiety.  She's used to having a garden and being able to walk.  What I found for her serves the open and airy feel, has a big garden, and the area is perfect for taking her for walks.  The cottages are set up so she can walk around in the open spaces - there's no real feeling of confinement, as there was at another space where I'd thought of placing her  - it was one long corridor with rooms off to the sides; she would have truly felt imprisoned!  The garden has benches and a gazebo.  The residents can walk into the garden and even go to the other cottage to visit, watch another tv show that isn't being viewed in the first, or just to walk around.
Quick snap of the gardens at St. A's.

2.   What services are included?  For Mom, we discovered she needed Physical Therapy, and to also hinder the onslaught of Parkinsonian Movement problems, we also needed a masseuse (even though on her own she'd never have thought of this).  Her facility provides the P/T, which she gets at least once a week, and they have resources which led me to her masseuse who specializes in geriatric massage at a very reasonable cost.  She is also allowed to participate in activities outside the Memory Care, including Book Groups, Bible Study, BINGO, and anything else that seems to warrant her interest; of course she needs to be attended, which can sometimes be an issue, but more than not she is able to participate.  The gardener also allows anyone interested to plant flower pots.  Mom's was the wonder of the garden last year!  She was quite proud!
Doctors, Dental, Eyes?  Transportation?  Activities?  Find out what's included - not everyone is as ambulatory as Mom, so unless they have an in-house care program, you may end up paying more for less!

3.  How Clean are the Facilities?  I did not see one facility that was filthy.  I did visit a couple that felt dark  and gloomy, which took them off the list.  We wanted brighter, and we found it!  Tons of windows, skylights, and light paint.
Narrow Shot of the Great Room in South Cottage

4.  How Many Residents Are In the Memory Care?  This is very important.  LBD patients (as a rule) tend to want fewer than more people around them.  Crowds tend to make them nervous.  Mom's cottage has 12 residents, as does the other cottage, but many aren't about much, except at dining times.  That's when Mom pops into her paper, magazines, or whatever medium she can, unless someone interesting is nearby.  When Mom is in a crowd, she becomes more agitated and has more issues with her speech and thought processes.  So, for her, this is a good number.
Dining Area in South Cottage (It's attached to the Great Room)

5.  How large are the rooms?  Mom's room is about 340 sq.ft.  Her bathroom is huge in order to accommodate a wheelchair easily.  It may feel a bit tight, but that's because we put in her grandmother's rocker, her easy chair, and a few other pieces to make it cozy and her own.  But it's good for her.  She has a window to the garden.  Other residents have a view of the front gardens and street of the building or the foyer courtyard.  Mom was quite fortunate.

6.  What Can You Expect From The Care?  How Long Will They Be Able to Help?  This is actually a very LARGE question!  What I discovered was that many facilities will allow a resident so long as they are mobile and physically functioning.  One facility which was highly recommended stipulated that once incontinence issues and mobility issues became difficult for staff, another placement needed to be found as soon as possible, as they weren't able to facilitate such issues.  This is extremely detrimental to the patient - changing living situations in times of great need can be devastating.
       When seeking a placement, find out whether they will be able to stay in that facility until (God Forbid) end-of-life.  Luckily, Mom's facility does just that. They are equipped to handle mobility, and other problems associated with all forms of dementia.
     I cannot stress just how important this element is.  If you have a loved one in a facility that isn't able to  provide continuous care, then begin seeking one that fits all your requirements as soon as possible - even if it means a waiting list.  Sooner is better than later.

Foyer between the North  and South Cottages Looking Out Into the Garden

7.  Costs and MedicAid.  I saw some extraordinary facilities that did not meet the above requirements.  I hear stories about many, as well.  There are many facilities that will not accept MedicAid no matter what.  So  if your loved one has a funding issue that requires them to, at some future point, rely on MedicAid, there are chances you will need to find (yes, I'm serious) another placement.  Not a good thing.

 8.  Communication - How well do they communicate with you?  I am in touch with the facility and the staff on a regular basis (not stalker-style, but an as needed basis) about Mom's schedule, needs, and updates.  I know many on staff, so it's pretty simple to get a good snapshot of how she's doing while I'm not there.
The Entryway to the Memory Care Cottages

9.  How Welcoming Is The Facility to Visitors?  I have to tell you, that when I first came to where Mom resides, I wasn't overly wowed!  However, upon entering her cottage I was floored!   There are areas in the Great Room where residents can visit, there's the garden, there is the tv room, there are the rooms, and there's even an anteroom in the foyer between the cottages on the inside for receptions, teas, and other activities.  It feels homey.  That's important.

10.  How Do They Deal with End Of Life?  This struck me this afternoon when I realized that one of the residents had passed over the weekend.  She was in her mid 90's, and a little quirky (I won't explain, just believe me).  I really did like her spunk!  Mom seemed surprised when she saw the photo next to the sign out sheet in the foyer.  She said a few things about her and then stated we needed to get going...  They do have memorials for the residents should the family want it, so there's some closure for everyone there.  But, as in Mom's case, in a month she won't recall much about her at all.  That's terribly sad, but just how much her brain has deteriorated.

So, that's it for now.  I'm sure I either glossed over something or missed something by a long shot.  Let me know!

Till Sunday!

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